超声引导下坐骨神经联合股神经阻滞麻醉对老年胫骨骨折患者的麻醉效果分析

Anesthetic Effect Analysis of Ultrasound Guided Sciatic Nerve Combined with Femoral Nerve Block Anesthesia in Elderly Patients with Tibial Fracture

目的:探讨超声引导下坐骨神经联合股神经阻滞麻醉对老年胫骨骨折患者的麻醉效果。方法:选取2020年8月—2022年8月枝江市人民医院骨科收治的100例老年胫骨骨折患者作为研究对象,根据麻醉方式分为对照组与观察组。对照组54例实施常规腰硬联合麻醉,观察组46例实施超声引导下坐骨神经联合股神经阻滞麻醉。比较两组麻醉效果、神经阻滞效果、术后疼痛程度、不良反应发生情况。结果:两组麻醉优良率比较,差异无统计学意义(P>0.05)。观察组感觉与运动神经阻滞起效时间短于对照组,感觉与运动神经阻滞维持时间长于对照组,差异有统计学意义(P<0.001)。观察组术后2、8、24、48 h VAS评分低于对照组,差异有统计学意义(P<0.001)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:超声引导下坐骨神经联合股神经阻滞麻醉在老年胫骨骨折患者中的麻醉效果显著,可缩短麻醉起效时间并延长维持时间,减轻术后疼痛感,且安全性较高。

Objective:To investigate the anesthetic effect of ultrasound guided sciatic nerve combined with femoral nerve block anesthesia in elderly patients with tibial fracture.Methods:A total of 100 elderly patients with tibial fracture admitted to Zhijiang People's Hospital from August 2020 to August 2022 were selected as the study subjects.They were divided into control group and observation group according to the anesthesia method.The 54 patients in the control group received conventional combined lumbar and epidural anesthesia,and 46 patients in the observation group received ultrasound-guided sciatic nerve combined with femoral nerve block anesthesia.Anesthetic effect,nerve block effect,postoperative pain degree and complications of the two groups were compared.Results:There was no significant difference in the excellent and good rate of anesthesia between the two groups(P>0.05).The onset time of sensory and motor nerve block in the observation group was shorter than that in the control group,and the maintenance time of sensory and motor nerve block in the observation group was longer than that in the control group,and the difference was statistically significant(P<0.001).The VAS scores at 2,8,24 and 48 h after surgery in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.001).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ultrasound-guided sciatic nerve combined with femoral nerve block anesthesia has a significant effect in elderly patients with tibial fracture,which can shorten the onset time and extend the maintenance time,reduce postoperative pain,and has high safety.